Improving Access to Care Through the Establishment of a Local, Teledermatology Network

Collin M. Costello, Helen J.L. Cumsky, Connor J. Maly, Jamison A. Harvey, Matthew R. Buras, Peter J. Pallagi, Anna L. Gustaveson, Davinder P. Singh, Steven A. Nelson, Mark R. Pittelkow, Aaron R. Mangold

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Introduction: Access to dermatologic care is a major issue in the United States, especially within the un- and underinsured populations; technology, including teledermatology, will pay a role in improving access to care. Methods: We performed a prospective study between November 2016 and September 2017. We leveraged a partnership between Mayo Clinic and Mountain Park Health Clinic, a community clinic that primarily serves un- and underinsured populations. We implemented a mobile phone-based store and forward (SAF) teledermatology service, which integrated an external community health clinic to an existing electronic health record (EHR) using standardized data capture forms, real-time support, and simple workflows. Results: Thirty-seven patients were enrolled in the study, 65% female and 35% male with an average age of 47.9 (SD = 15.9). The ethnic breakdown was: 81.1% Hispanic, 13.5% Caucasian, and 5.4% African American. The majority, 62.2%, did not have a high school education, 45.9% were unemployed, and 51.4% were uninsured. 64.9% earned less than $25,000 for annual household income. Teledermatology consultation increased the absolute diagnostic and management concordance by 36.6% (p = 0.01, 95% CI 12.2%-61.0%) and 34.2% (p < 0.01, 95% CI 11%-57%), respectively. Primary care providers had a significant increase in mean confidence in the diagnosis and management of dermatology conditions pre and poststudy (3.60 vs. 3.70 and 3.21 vs. 3.60, respectively; p < 0.01). Ninety-six percent of the primary care providers agreed (52.0%) and strongly agreed (44.0%) that they would send another patient for teleconsultation.Conclusion: We successfully implemented a SAF teledermatology consultative service in a community health clinic outside our EHR. A similar approach can be used by other large health care organizations to provide integrated, high-quality consultation to clinics with rural, un- and underinsured populations.

Original languageEnglish (US)
Pages (from-to)935-940
Number of pages6
JournalTelemedicine journal and e-health : the official journal of the American Telemedicine Association
Volume26
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • dermatology
  • education
  • teledermatology
  • telemedicine

ASJC Scopus subject areas

  • Health Informatics
  • Health Information Management

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    Costello, C. M., Cumsky, H. J. L., Maly, C. J., Harvey, J. A., Buras, M. R., Pallagi, P. J., Gustaveson, A. L., Singh, D. P., Nelson, S. A., Pittelkow, M. R., & Mangold, A. R. (2020). Improving Access to Care Through the Establishment of a Local, Teledermatology Network. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 26(7), 935-940. https://doi.org/10.1089/tmj.2019.0051